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A literature review of the long case and its variants as a method of assessment

Thornton, Simon, (2012) A literature review of the long case and its variants as a method of assessment. Education in Medicine Journal, 4 (1). e5-e14. ISSN 2180-1932

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Official URL: http://www.saifulbahri.com/esubmission/index.php/eimj/article/view/9/16

Affiliations

University of Bristol, UK. North Bristol NHS Trust

Abstract

Objective: The purpose of this literature review is to review the evidence base for the long case and its variants as a reliable method of assessing medical students.
Method: MEDLINE, PubMed, EMBASE, Blackwell Synergy, Ask Eric and Google Scholar were searched for articles published between 1991 and 2011 using the keywords long case, OSLER, clinical assessment and clinical examinations.
Result: 29 articles were identified, 13 original research articles and 16 review articles and commentaries. The majority of studies are single centre cohort studies, providing relatively weak evidence. The strengths and weaknesses of the long case are discussed with a review of the literature.
Conclusion: Despite it being viewed as a relatively authentic examination, concerns regarding reliability of the long case examination has led to its use being discontinued in many UK medical schools. However, there is evidence that with simple modifications, the reliability of the long case can be improved to be as good as, if not better than alternative clinical examinations such as the Objective Structured Clinical Examination (OSCE).

Item Type:Journal
Keywords:Long case, OSLER, Assessment, DOCEE.
Subjects:R Medicine, Dentistry, Pharmacy, Nursing
L Education
ID Code:12378

1. A. Dare, A. Cardinal, J. Kolbe and W. Bagg, What can history tell us? An argument for observed history-taking in the trainee intern long case assessment., The New Zealand Medical Journal 121 (2008).

2. S.Smee, ABC of learning and teaching in medicine. Skill based assessment., British Medical Journal 326 (2003).

3. N. Teoh and F. Bowden, The case for resurrecting the long case, British Medical Journal 336 (2008).

4. R. Sood, Long Case Examination - Can it be Improved?, Journal of the Indian Academy of Clinical Medicine 2 (2001).

5. J. Norcini, The death of the long case?, British Medical Journal 324 (2002).

6. I. Reece and S. Walker, Teaching, Training and Learning, Business Education Publishers, Sunderland (2007).

7. V. Wass, C. Van der Vleuten, J. Shatzer and R. Jones, Assessment of clinical competence, Medical Education Quartet 357 (2001), pp. 945-949.

8. G. Miller, The assessment of clinical skills/competence/performance., Academic Medicine 65 (1990).

9. F. Gleeson, Assessment of clinical competence using the Objective Structured Long Examination Record (OSLER), Medical Teacher 19 (1997), pp. 7 14.

10. G. Norman, The long case versus objective structured clinical examinations, British Medical Journal 324 (2002), pp. 748-749.

11. T. Luiz, R. Dantas, J. Fernando, E. Ferriolli, J. Moriguti, A. Martinelli, et al., A standardized, structured long-case examination of clinical competence of senior medical students., Medical Teacher 22 (2000), pp. 380-385.

12.L. Olson, J. Coughlan, I. Rolfe and M. Hensley, The effect of a Structured Question Grid on the validity and perceived fairness of a medical long case assessment, Medical Education 34 (2000), pp. 46-52.

13.V. Wass and B. Jolly, Does observation add to the validity of the long case?, Medical Education 35 (2001), pp. 729-734.

14.T. Wilkinson, P. Campbell and S. Judd, Reliability of the long case, Medical Education 42 (2008), pp. 887-893.

15.H. Hamdy, K. Prasad, R. Williams and F. Salih, Reliability and validity of the direct observation clinical encounter examination (DOCEE), Medical Education 37 (2003), pp. 205-212.

16.T. Wilkinson, L. D'Orsogna, B. Nair, S. Judd and C. Frampton, The reliability of long and short cases undertaken as practice for a summative examination, Internal Medicine Journal 40 (2010), pp. 581-586.

17. C. Van der Vleuten, Making the best of the 'long case', The Lancet 347 (1996), p. 704.

18. A. Dugdale, Long-case clinical examinations, The Lancet 347 (1996), p. 1335.

19. L. Olson, The ability of a long-case assessment in one discipline to predict students' perfomances on long-case assessments in other disciplines, Academic Medicine 74 (1999), pp. 835-839.

20. J. Price and J. Byrne, The direct clinical examination: an alternative method for the assessment of clinical psychiatry skills in undergraduate medical students, Medical Education 28 (1994), pp. 120-125.

21. V. Wass, R. Jones and C. Van der Vleuten, Standardized or real patients to test clinical competence? The long case revisited, Medical Education 35 (2001), pp. 321-325.

22. N. Teoh and F. Bowden, The case for resurrecting the long case, British Medical Journal 336 (2008), p. 1250.

23. J. Norcini, L. Blank, D. Duffy and G. Fortna, The mini-CEX: a method for assessing clinical skills, Annals of Internal Medicine 138 (2003), pp.476481http://www.biomedcentral.com/1472-6920/9/68

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